All Head Injuries Aren't Equal

Your horse bucks and you fall off, luckily landing on your feet, though hard enough to rattle your head. Within a few minutes, you feel fine and resume riding. Research is showing, however, that you may want to rethink mounting up so quickly after a fall, and, at the very least, you need to keep a close eye for signs that you’ve suffered a concussion.

Diverse and extensive multisport research suggests that a potentially infinite spectrum of incidents can damage the brain and the impact threshold for injury varies dramatically from person to person. “We’ve known for some time that you don’t have to be hit in the head to be concussed,” explains Drusilla (Dru) Malavase, a longtime rider-safety advocate and member of ASTM International’s Equestrian Headgear Committee. “It can happen in a whiplash situation or in a fall in which you land on your feet.” It’s now clear that hard-to-measure characteristics like heredity, hydration and previous impacts, even very minor, can make a difference, too. One person may walk away from an accident that created 300 Gs (gravitational force) of energy—the current threshold for the ASTM equestrian helmet standard—while another person’s brain could be injured from an impact involving 50 Gs.

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A March 18 article in The New York Times noted that the American Academy of Neurology has revised its concussion treatment guidelines in favor of case-by-case analysis, because “concussions are too idiosyncratic to be categorized neatly.” Attempting to account for all the variables in new ASTM headgear standards is affectionately known as an “impossibiliun,” Dru notes with a chuckle, but that has not stopped the committee from continuing to update and refine its standards. “One thing we are now considering is a low-impact test for helmets because it may be that concussions are happening in less severe impacts,” she says.

The Safety Facts

When the ASTM standard for equestrian helmets was finalized in 1988 and the first certified helmets arrived in 1989, the number of reported horse-related fatalities in the United States was pegged at 250, roughly 60 percent resulting from head injuries. Today, those numbers are about half. They are likely to keep dropping as more riders choose—or are required by competition rules—to wear ASTM/ SEI (Safety Equipment Institute)-certified helmets. It’s really a no-brainer considering such headgear is estimated to reduce the risk of death from head injury by 70 to 80 percent and the growing evidence of the brain’s fragility.

Drawn from emergency-room admission reports, the stats represent all types of horse-related injuries, approximately 70,000 every year, and their compilation is not an exact science, Dru notes. While the numbers aren’t perfect (hospitals don’t distinguish whether someone fell off or was kicked in the head, for example), they clearly reflect a decline in head injuries that’s commensurate with the rise in awareness of how certified helmets can help protect the brain in common and notso- common riding accidents. One telling detail is that hospitals report more head injuries among horse-people 35 and older, suggesting that younger equestrians view helmets as they do seatbelts: a necessary part of the ride.

Within and beyond equestrian sport, there’s rapidly growing understanding of head injuries, their myriad causes and wide-ranging effects. These can include obvious impairments to almost-imperceptible mental deficits like tiny, but critical, delays in reaction times.

Olympic dressage rider Courtney King Dye’s 2010 brain injury, sustained when her horse tripped during schooling while she wasn’t wearing a helmet, vaulted the helmet issue into the equestrian public’s consciousness. The campaign spearheaded by Riders4Helmets shortly thereafter has kept the issue front and center. These sport-specific awareness efforts coincide with new knowledge about traumatic brain injuries and attempts to advance protective headgear across all sports to keep pace with these revelations.

As an ASTM committee member and co-chair, Dru has been privy to information drawn from analysis of more than 1 million head injuries sustained in football, much of it taken from helmets instrumented to record the force of impact. “The great thing about ASTM is that it works on headgear standards for various sports,” Dru explains. “Even though equestrian is not funded like the National Football League, we can take advantage of their research. After all, the head does not know in which sport it has been injured.”

How Helmets Help

To meet ASTM standards, equestrian headgear must protect the rider’s head from an impact of 300 Gs. To test this, a helmet is strapped onto a head form then dropped at the necessary speed onto both a flat anvil and an anvil with a 30-degree angle meant to mimic a horse shoe, jump standard or other sharp object likely to be encountered in a fall from a horse. The protection primarily comes from the helmet’s shock-absorbing liner, which slows down the force of the impact, thus reducing the force at which the brain is knocked against the inside of the skull.

Tests of the harness or “retention system” are also part of the certification process because the harness is critical to holding the helmet in an effective position at the moment of impact. New helmets seeking certification undergo these tests, and those already certified are regularly retested to ensure ongoing compliance.

The ASTM 1163-04a standard was updated this year to 1163-13. This adds an additional, smaller head form to the testing requirements but is not likely to trigger significant changes in helmet design and construction.

Dru reports that all certified helmet makers design their headgear to exceed, sometimes by a large margin, the ASTM standard. But, you won’t find these specifics in the label or product information due to potential liability issues. Even if you could, the infinite number of variables that contribute to an individual’s risk of head injury make it impossible to say that one SEI-certified equestrian helmet is safer than another. The one exception is in the number of fit options the helmet offers, because fit is critical to its protective capabilities. Otherwise, “The price is not indicative of the protective qualities of the helmet,” Dru states.

Helmet Options

Proper fit is accomplished in various ways. In some lines, the entire helmet is available in one-eighth-inch increments from, typically, 6 3⁄8 to 7 3⁄4. Other companies offer three to five outer-shell sizes and use liner inserts of various thicknesses to accommodate individual head sizes and shapes. An adjustable harness is often part of the helmet’s fit mechanism, and some use a dial-fit system to customize the size appropriately.

“Look at the list of SEI-certified equestrian helmets and it is staggering how many manufacturers and different helmets are on it,” Dru notes. “It’s impossible to say that you can’t be fitted properly, and that’s been the case for the last ten years.” The 77-year-old Dru, who stopped riding just a few years ago, wears a size 7 helmet and has yet to have a problem finding a certified, affordable one to fit her head size and shape.

Appearance and comfort don’t technically contribute to the helmet’s safety, but manufacturers rightly give these qualities equal attention because they do affect the most critical aspect of all: whether the helmet gets worn. These are the areas of most obvious advances in today’s new helmet collection.

Light weights, streamlined shapes and both traditional and progressive colors, finishes and accents are among new helmet attributes. Cooler heads prevail thanks to vents and airflow-oriented design, and many helmets have removable liners that are made of moisture-wicking, washable materials.

It’s getting harder to find a non-certified helmet for sale in North America. Headgear marketed as a “hat” or “cap” is usually a piece of attire that offers no protection. Leave no doubt by looking for the permanently affixed SEI label verifying the helmet’s certification. It’s also crucial to follow the manufacturer’s fit, care and maintenance instructions. Because the helmet, not your head, is meant to crumple on impact, you will need to replace it, or at least have it checked, if you take a spill in which your head hits something with any force. Most manufacturers have generous replacement policies, providing you registered the helmet when you bought it and have kept your proof of purchase. (For more on this, see “Replacement Policies,” page 58.)

The new helmets featured at right give a glimpse of the multitude of options available. Given that you can get an ASTM/SEI-certified helmet for under $30, there is truly no excuse not to strap one on.

Helmet Headliners:

Tipperary Pink Sportage 8500

Special features: Made from lightweight, high-density ABS (highimpact plastic) material for superior impact resistance. Contoured dropback shell and comfort foam interior cradle for extra protection. Rear reflective strip and flexible visor. Cutaway profile with a carbon-fiber-look finish. A portion of pink helmet sales through October 31, 2013, will be donated to breast-cancer research.

Retention & fit: Four-point harness with exclusive YKK adjuster clip and buckle that are positioned to stay off the face for comfort. Easy-adjust dial system with extra-strong “teeth” in the dial for long life

Colors & finish: Black/ black, black/brown, black/navy, each with a rubberized finish and reflective piping in a silver-frosted V accent

Sizes: S/M and M/L

Price: $94.95

Contact: www.ovationriding.com

Devon-Aire Matrix

Special features: Liner with “Conehead” technology reduces impact by absorbing the force and distributing the energy in a lateral motion, away from the head. Unique shape directs force to points where foam is most dense. Ultralightweight for comfort

Sizes: S, M, L and XL shells with two included inserts for proper sizing. Additional inserts sold separately

Price: $199.95

Contact: www.irhhelmets.com

Uvex Perfexxion

Special features: One of the first of this German-engineered and -made line of helmets to be introduced to the U.S. market, the Perfexxion has a unique fitting system, the IAS 3D, that enables the depth of the helmet to be adjusted to various head shapes and different hairstyles. The super-lightweight construction incorporates various technologies from the cycling world. The removable, machine-washable lining is hygienic, antibacterial, anti-allergy and moisture-wicking to prevent bacteria and odor.

Retention & fit: Fully adjustable with synthetic leather chin-strap cover for easy cleaning. Does not sweat, stain or rot, and the buckle is built for one-handed use. The IAS 3D fitting system accommodates various head shapes and sizes in millimeter increments for a safe and secure fit.

Colors & finish: Five styles, ranging from “classic” to “glamour,” include a wide range of colors and finishes from carbon to ultrasuede. Smooth, wipe-clean finishes are among many available options.

Sizes: XXS–XL shell sizes, with three additional sizes and shapes facilitated by the IAS 3D with each shell

Price: $229–$399

Contact: www.gemtack.com

Charles Owen 4Star

Special features: Certified to meet the top four international safety standards, this deep-fitting helmet incorporates the latest high-tech fibers for improved crush resistance.

Ventilation: “Free Fit” system allows for increased airflow across the forehead, 10 vents and front air channel with Coolmax . mesh to aid cooling and evaporation of sweat

Color & finishes: Shadowmatt in black and midnight blue with crystal options. Premium helmets in black, brown and navy blue, with choice of leather or matte Alcantara finish and several choices for top stripe

Special features: Advanced ventilation system, uniquely tailored fit for any head shape in a shell made of the latest impact-absorbing materials

Ventilation: A translucent honeycomb structure built into the helmet’s surface keeps head cool in hot weather and during heavy activity.

Retention & fit: Harness features the CASCO Loc for security and easy adjustment. Honeycomb mesh stretched across the helmet’s interior provides fit for all head shapes and holds helmet in place without touching the head.

Colors: Carbon-fiber, black, white

Sizes: S, M, L

Price: Approximately $650

Contact: www.pillasport.com

This article originally appeared in the June 2013 issue of Practical Horseman.